1983, 10-10 Permit: 83B-0168 Heater, PipingPLAN NUMBER APPL ICAT ION /PERMIT
_ SPOKANE COUNTY - DEPARTMENT OF BUILDING & SAFETY
NORTH 611 JEFFERSON / SPOKANE, WASHINGTQN 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
STREET ADDRESS PARCEL NO.
1. I Q O 2 (D 39-11`
2.
LOT I BLOCK I SUBDIVISION LEGAL DESCRIPTION:
O. ER PHONE PHONE
3. MAILING ADDRES ZIP Actual Set Backs in Feet to:
C) Z( -D 3 113:�
North South East
I West
CONTRACTOR
LICENSE EXPIRES
PHONE
Size of Parcel
Zone Classification
Residential ❑
Commercial ❑
4. ADDRESS
ZIP
Type Const. Occupancy
Sprinklered
Dyes ❑No ❑Req'd.
DESIGNER
PHONE
New Const. Valuation
Remodeled Valuation
Total Bldg. Floor area
5. ADDRESS
ZIP
Main Floor Upper
Floors
Garage/Storage
Greenhouse
CHANGE OF USE FROM
TO
Cover Deck
Uncv. Deck
Fin. Basement
Unfin. Basem<
6.
No. Baths No.
Floors
No. Fin. Rooms
No. Dwellings
EW ❑ AD' El RPL. El MVE.
TYPE ❑ALT.
7. OF ❑ OTHER
ElBLD. ❑ PLMB. ECH. ❑ M. H. ❑ POOL
Exempt.
Required
Yes❑ No❑
Number
WORK
o�rVifi.o
Received
Yes❑ No❑
DESCRIBE WORK
Shorelines/ Flood Hazard
Plans Required ❑
8.��
Yes❑ Not Applic. ❑
Received ❑
VALU TION
oURCE
GAS
EL CTRI
WATER
El
SEWAGE
Ownership
FEES COLLECTED
9
OF
UTILITIES
PRtIVATE ❑
SEWER O
Public ❑ Private ❑
I hereby certify that I have read and examined this application and have read the "NOTICE"
provisions included on
reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this type of
Building
work will be complied with whether specified herein or not. The granting of a permit does not presume to give au-
thority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. SEE REVERSE SIDE FOR RE RED INSPECTIONS
Plumbing
SIGNATURE OF APPLICATION
OWNER OR AGENT
DATE O
Mech.
SPECIAL APPROVALS
SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE)
Plan Check
IIIISELIM. FINAL DATE
I
Env. Health
1 /
SEPA
Planning
1
,A6�c)_
Modular/
MFG. Home
Fire
Prevent.
_
Other (Specify)
Utilities
TOTAL $
SEPA
WHEN MACHINE VALIDAT
Plans PERMIT IS NONTRANSFERABLE THIS BECOMES A PERMIT.
Exam. PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED
TTeecihing M01 IN 180 DAYS DATE "I^M'10
PERMITNUMBER pp��
B C [ U5
0
Ir
PERMIT NJ U' U z * l O 0 -AL